In the years since World War II, the United States has grown increasingly dependent on foreign-born healthcare personnel at all levels of the healthcare system. Foreign-born nurses report that while they may feel clinically competent, they often feel unprepared for the use of English in the healthcare setting (Davis & Nichols, 2002; Guttman, 2004). Immigrant health professionals experience communication difficulties with patients and coworkers that are easily exacerbated in a healthcare setting where situations can quickly become emotionally charged and stressful. Their U.S.-born peers identify a number of difficulties in working with foreign-born nurses, including lack of communication skills and differences in decision making, behavioral norms, role expectations, and attitudes (Yi & Jezewski, 2000). Patients may express distress at being unable to understand physicians who are not native English speakers, and, whether their complaints reflect prejudices or not, they are undermining for the immigrant practitioner (McMahon, 2004). To address the need of foreign-born nurses for continued language and cultural support, the authors of this article developed and evaluated the first phase of a multimedia, Internet-based educational tool, the Intercultural Communication Workshop (ICW), designed to improve the overall communicative competence of foreign-born nurses. Participants in the ICW learn a three-fold set of rules for improving their speech intelligibility: consonant clarity, vowel accuracy, and appropriate intonation (Sikorski, 2005a). Instruction in the ICW is tailored to the healthcare workplace whenever possible and includes contextual information about communication, culture, and healthcare in the United States, thereby avoiding the "one size fits all" approach to second language instruction. The Intercultural Communication Workshop is designed as a supplement to formal in-person instruction and orientation programs. When such programs are lacking, this e-learning course can stand alone as self-paced instruction. While some may argue that the ICW cannot take the place of face-to-face interactions in a well-designed and executed ESL course, the e-learning environment offers several advantages: it is self-paced, private (thus less threatening), and provides continuous opportunities for practice and reinforcement.